| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | REGENCE BLUE SHIELD | $670K | $223K | $893K | 6.33% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $181K | — | $181K | 7.24% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | DELTA DENTAL OF WASHINGTON | $78K | — | $78K | 7.00% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | ASURIS NORTHWEST HEALTH | $27K | $524 | $27K | 4.85% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $23K | — | $23K | 7.06% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | LIFEMAP ASSURANCE COMPANY | $13K | — | $13K | 9.58% |
| CAPITAL BENEFIT SERVICES, INC.3 | 15375 SE 30TH PLACE, SUITE 380 BELLEVUE, WA 98007 | MAGELLAN HEALTHCARE | $2K | — | $2K | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EPK & ASSOCIATES NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Direct payment from the plan; Accounting (including auditing); Other services Service code 10 | 15375 SE 30TH PL., STE 380 BELLEVUE, WA 98007 | $358K |
| ANASTASI, MOORE & MARTIN, PLLC EIN 20-8149084 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $14K |
| KIBBLE & PRENTICE NONE | Insurance services; Direct payment from the plan Service code 23 | 601 LAKE UNION ST., SUITE 1000 SEATTLE, WA 98101 | $9K |
| KUTCHER, HEREFORD, BERTRAM, BROWN NONE | Legal; Direct payment from the plan Service code 29 | 705 SECOND AVE., SUITE 800 SEATTLE, WA 98104 | $5K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 3,402 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,402 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | REGENCE BLUE SHIELD | 2,053 | $17.5M |
| Dental | DELTA DENTAL OF WASHINGTON | 1,758 | $1.1M |
| Vision | LIFEMAP ASSURANCE COMPANY | 2,484 | $139K |
| Life insurance | LIFEMAP ASSURANCE COMPANY | 2,484 | $139K |
| Other | LIFEMAP ASSURANCE COMPANY | 2,484 | $139K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,484 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.